Open versus arthroscopic surgery for internal derangement of the temporomandibular joint: a retrospective study comparing two centres' results using the Jaw Pain and Function Questionnaire.

OBJECTIVES: Surgical procedures currently used for treating of internal derangement of the temporomandibular joint vary widely. Although different studies present favourable results following open or arthroscopic TMJ surgery, the criteria for a successful treatment outcome are not always defined identically. In a retrospective study, two groups of patients who underwent either open or arthroscopic surgery for internal derangement (stages III-V according to Wilkes' classification) were investigated using the so-called JPF-Questionnaire.

PATIENTS AND METHODS: The Kyoto collective (group 1) consisted of 28 patients, 2 men and 26 women, who underwent arthroscopic surgery. At the time of surgery, age ranged from 13 to 77 years (mean 32.8 y). The postoperative follow-up period ranged from 4 years and 4 months to 5 years and 9 months. Twelve of the 28 patients were classified as stage III, 10 as stage IV and 6 were classified as stage V (according to Wilkes) at the time of surgery. The Vienna collective (group 2) also consisted of 28 patients, 2 men and 26 women, who underwent open meniscoplasty or discectomy. At the time of surgery age ranged from 17 to 55 years (mean 31.6 years). The postoperative follow-up ranged from 5 to 6 years and 9 months. Fourteen of the 28 patients were classified as stage III, 11 as stage IV and 3 were classified as stage V (according to Wilkes) at the time of surgery. The results of the JPF-Questionnaire of the two groups were compared by Wilcoxon 2-sample tests. The Japanese version was applied, while in Austria the German version of this questionnaire was applied.

RESULTS: At a level of significance alpha=0.05 no significant difference was found when comparing the subgroups (Wilkes stages III, IV and V) or both groups of patients 5 years after temporomandibular joint surgery.

CONCLUSION: There cannot be any clear indication for only one of the treatment modalities as similar results were noted following open or arthroscopic temporomandibular joint surgery. Nevertheless, arthroscopic surgery is a minimally invasive procedure resulting in a shorter or no time of hospitalization when compared with open surgery and therefore is preferred by many surgeons nowadays.